This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!

--My "facts" are not your "facts", and so therefore I have nothing to offer you that fits your definition.

I would say that facts, true knowledge, consist of beliefs that are true and justified by reference to reality.

You are offering beliefs, not facts. We have no reason to believe that they're true; there's no good sound evidence to back them up.

In other words, the Cochrane review is evidence-based; your personal experiences are not.

Yes, I was on the final Brewer version of the diet. Yes, my midwife was careful to ask about my activity level etc. and encouraged me to add additional calories to my diet. Yes, I ate the eggs. No, it didn't work.

I am very interested to hear what about the diet you think we have mischaracterized. As I understand him, Brewer's proposed mechanism is that the blood volume is inadequately expanded as a result of poor dietary protein, calorie, salt, and fluid intake to support a pregnancy. He also suggests, as do you, that it would be possible to reverse preeclampsia via dietary changes.

Here's a link to a brief explanation of the mechanism as currently understood by researchers, as elucidated just by the women on this site: http://www.preeclampsia.org/forum/viewtopic.php?t=16607

I would like an explanation for how modifying diet in the third trimester is supposed to reverse the shallow implantation which occured in the first trimester. We know, insofar as we know anything, that the placentas in preeclamptic pregnancies are often shallowly implanted -- we have scientific studies showing this, and elucidating the mechanism.

But we have no reason to suspect that adding albumin to the bloodstream will reverse this process -- I cannot find a single study in PubMed suggesting that it serves any purpose other than having some predictive value. sFlt-1 also has some predictive value. sEng also has some predictive value. Lots and lots of plasma values are off in preeclamptics; albumin is just one.

This study, dating from 1998, is illustrative with respect to albumin values:
http://tinyurl.com/26y7vm

Quoting the abstract:

A decrease in serum albumin concentrations is an almost inevitable finding in disease states, and is primarily mediated in the acute phase by alterations in vascular permeability and redistribution. This change is not disease specific but marked changes that persist are generally associated with a poorer prognosis. Critical appraisal of long-standing practices and the availability of alternative colloid solutions have led to a reduction in albumin replacement therapy, and a widespread tolerance of lower albumin concentrations in patients. The factors determining serum albumin concentrations, their measurement and the implications of hypoalbuminaemia are reviewed. The clinical value of serum albumin measurement is discussed.

Wendy, I intended no offence, and I regret that you were hurt by my words.

I am also sorry that I remembered incorrectly about who it was that sounded as though my being able to join the debate was conditional. It was actually Caryn...
"If you can come back with peer-reviewed data showing a relationship, then we can chat some more."

Based on my earlier interaction with Laura, I think that our world views and belief systems are too different for our being able to have a helpful discussion on this subject.
http://www.davis-floyd.com/ShowPage.asp?id=51
("The Technocratic Body: An American Childbirth as Culteral Expression")

I also think that we may end up just repeating ourselves from this point onwards.

I am willing to answer any questions regarding the BD, and I am willing to correct any inaccuracies about the BD that were in this thread, with permission from a moderator. But I am also willing to accept that that service is not welcome on this board, and I understand why.

I do understand - considering the way some other sites are managed - that you feel you may be suppressed here. However, I am certain no one has asked you to stop posting, so forgive me if we seem somewhat confused by your constant reference to being 'muzzled' and needing 'permission'. I just want to make it absolutely clear to our members and any lurkers that this discussion is exactly as it stands - there have been no deletions and no offline reprimands.

But it seems perfectly obvious that we must come to some point of agreement about what we are debating. My impression - and forgive me if I misrepresent you - is that we are simply expected to accept your word that Brewer is a catch all cure (save for those of us with conditions that might predispose us to preeclmapsia) because it has been your experience that it is so.

You can produce no data beyond what Brewer himself said and we have patiently and systematically addressed that for your benefit on this thread.

If you have an argument beyond simply what you believe to be true, then you are welcome to provide it. As you can see, we really are not averse to discussing this - it is something that affects us as a group more than any other.

For the benefit of any members and lurkers, I will confirm that there have been no deletions or offline reprimands.

I have felt the clear message, however, that if I cannot provide peer-reviewed documentation regarding the validity of Dr. Brewer's thesis and program, then nothing else that I have to say is welcome here. Have I misunderstood that? I'm willing to accept that I've misunderstood, if I have.

I have also thought that I heard that any reference to the BD is probably hurtful to many people here, because of the many negative connotations that that topic carries with it for many people. Have I misunderstood anything there?

I wanted to clarify some things about the BD that might have been misunderstood here. But if any mention of that system is hurtful and obnoxious to people here, then it's best that I stay quiet with that information.

That is why I need to know what is allowed before I step out. And I'm also willing to leave this thread where it's landed and move on.

I have felt the clear message, however, that if I cannot provide peer-reviewed documentation regarding the validity of Dr. Brewer's thesis and program, then nothing else that I have to say is welcome here.

Joy, it is not that you are not welcome, it is that I think we are further on in the discussion of Brewer than you give us credit for. Our position has been backed up with one study after another. You are asking us to simply take your word for yours.

From the last link you provided, I can only infer that you fear and distrust science, technology and hospital birth - and clearly you don't see the validity of peer-reviewed data. As I am certain that you are aware that we represent a group of women that stand to die in childbirth without intervention, you will forgive us for requiring a more rigorous approach.

I have felt the clear message, however, that if I cannot provide peer-reviewed documentation regarding the validity of Dr. Brewer's thesis and program, then nothing else that I have to say is welcome here.

Frankly, yes. However, that need not necessarily be the inevitably unsatisfactory end to this dialogue. Why not persue the option of validating Dr. Brewer's diet, or at a minimum identifying why it appeared to work for so many? We already understand that preeclampsia is a syndrome, ie. a disease that may be triggered by several independent factors that leads to a common situation (compromised placenta) that ultimately results in a physiological condition that continuously worsens. Only committed and organized studies could resolve whether or not a specific dietary regimen could help reduce or ameliorate this condition. It's not as if mechanisms for funding such research don't exist. The NIH is committed to funding investigations and evaluations of "alternative medicine", and might be willing to consider supporting a study. This can only come from the community that applies the Brewer approach. Nobody else would be sufficiently experienced and I doubt very much that having it run by research OBs would be acceptable to the community who use it. Don't assume that the women on this board would not be happy to see positive results. If we'd willing to inject blood thinners on a daily basis for months before and after delivery, I'm pretty sure we'd follow a clinically prescribed and research supported diet.

*I am actually suggesting that you read the research that has already been done on the Brewer Diet, and the research that the Brewer Diet was founded on.

--Fiona:"From the last link you provided, I can only infer that you fear and distrust science, technology and hospital birth - and clearly you don't see the validity of peer-reviewed data."

*Not exactly true. I don't fear any of it. I distrust much of it, because I believe that it is based on some false assumptions, or at least beliefs that I don't share, as described in the writings of Ms. Davis-Floyd, and the writings of Dr. Marsden Wagner (marsdenwagner.com).

And I've seen the results of the models that hospital births and home births are based on, as I've worked in both situations, and the results of the latter seem more in keeping with the true human design, to me.

*I see the validity of peer-reviewed data in concept, if the process could be kept pure. I doubt that it can be kept pure, in this world where power is a big goal for so many. I also have no reason to trust any of the studies that you have posted for me, because I don't know any of the researchers or have any reason to trust their biases or education or process.

--Fiona:"As I am certain that you are aware that we represent a group of women that stand to die in childbirth without intervention, you will forgive us for requiring a more rigorous approach."

*I most certainly do.

--Catherine:"Why not persue the option of validating Dr. Brewer's diet, or at a minimum identifying why it appeared to work for so many? The NIH is committed to funding investigations and evaluations of "alternative medicine", and might be willing to consider supporting a study. This can only come from the community that applies the Brewer approach. Nobody else would be sufficiently experienced and I doubt very much that having it run by research OBs would be acceptable to the community who use it."

*Great idea! I hope somebody is doing that or will do that soon. That I would LOVE to see!

--Catherine:"Don't assume that the women on this board would not be happy to see positive results. If we'd willing to inject blood thinners on a daily basis for months before and after delivery, I'm pretty sure we'd follow a clinically prescribed and research supported diet."

*I am actually suggesting that you read the research that has already been done on the Brewer Diet, and the research that the Brewer Diet was founded on.

I also have no reason to trust any of the studies that you have posted for me, because I don't know any of the researchers or have any reason to trust their biases or education or process.

Joy, I'm not sure why you assume I - or anyone else here - haven't read up on Dr Brewer and his work. Because we don't accept it as proven fact?

I would have hoped that, at the very least, you would have realised that we are avid readers of everything and anything to do with preeclampsia and that we do devote considerable time and effort to keep up with current research.

And are you really saying that you do not trust any of the scientific studies we have cited (which I am sure you have made every effort to read) because you are not personally aquainted with those involved?

I am actually suggesting that you read the research that has already been done on the Brewer Diet, and the research that the Brewer Diet was founded on.

But we have, and one of the things we've noticed about it is that it's never been confirmed in any follow-up research, and that no current preeclampsia science accepts the Brewer model for the development of the disease.

In that respect, it's very like reading any scientific theory that's been superceded by newer theories. Like, say, the geocentric theory of the solar system. Brewer predates the general acceptance in the scientific community of the theory of plate tectonics. His advocates have had a lot of time to produce some actual, peer-reviewed data.

I wouldn't expect any current researchers to pick this ball up -- no one's going to spend a lot of time on 40 year old unpublished data -- but I would very much like to see the natural birthing community take the lead on this. As I've mentioned, I've talked to NICHD people who are interested in funding this, and if you would be interested in coordinating a study population or know someone who would, contacting me or any of the other moderators through our profiles would be a good way to get moving on this topic.

I would disagree that knowing researchers personally is a useful way of evaluating the quality of their work, especially when peer-review can do that for you.

We would all love to see some sort of positive intervention that would lead to reduced or eliminated preeclampsia rates and lower maternal and fetal mortality and morbidity.

I am actually suggesting that you read the research that has already been done on the Brewer Diet, and the research that the Brewer Diet was founded on.

But we have, and one of the things we've noticed about it is that it's never been confirmed in any follow-up research, and that no current preeclampsia science accepts the Brewer model for the development of the disease.

In that respect, it's very like reading any scientific theory that's been superceded by newer theories. Like, say, the geocentric theory of the solar system. Brewer predates the general acceptance in the scientific community of the theory of continental drift. His advocates have had a lot of time to produce some actual, peer-reviewed data.

I wouldn't expect any current researchers to pick this ball up -- no one's going to spend a lot of time on 40 year old unpublished data -- but I would very much like to see the natural birthing community take the lead on this. As I've mentioned, I've talked to NICHD people who are interested in funding this, and if you would be interested in coordinating a study population or know someone who would, contacting me or any of the other moderators through our profiles would be a good way to get moving on this topic.

I would disagree that knowing researchers personally is a useful way of evaluating the quality of their work, especially when peer-review can do that for you.

We would all love to see some sort of positive intervention that would lead to reduced or eliminated preeclampsia rates and lower maternal and fetal mortality and morbidity.

Caryn, you took the words right out of my mouth.
Joy you are suggesting we "read the research" but many of us have...we have read anything and everything we can get our hands on that even vaguely relates to PE. I find it odd that after being on this discussion with us, you would still believe that we must not have read the research or we would believe. Show me PROOF. Hard, evidenciary proof, done in a scientific maner, written up in a peer reviewed journal, a study that can be duplicated, and I would be jumping on that band wagon in a second.

You also say...
"And I've seen the results of the models that hospital births and home births are based on, as I've worked in both situations, and the results of the latter seem more in keeping with the true human design, to me."
I think no one would disagree with you on the point that it is more keeping with human design to have a natural child birth, butr due to this disease this dream was ripped away from many of us. And we have seen the results of hospital births vs home births to, and I for one know that a hospitall birth saved my life.